Provider Demographics
NPI:1184919987
Name:HARTMAN, KRISTI L (MD)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:L
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6614 SANGER AVE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-4253
Mailing Address - Country:US
Mailing Address - Phone:254-537-6100
Mailing Address - Fax:254-537-6101
Practice Address - Street 1:6614 SANGER AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-4253
Practice Address - Country:US
Practice Address - Phone:254-537-6100
Practice Address - Fax:254-537-6101
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4454207Q00000X
TXBP10038564207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine